﻿<?php include("prospect_top.php")?>
		<fieldset>
		<legend align="center">Adresse de facturation</legend>
			<label for="nomfact">Nom :</label>
			<textarea name="nomfact" id="nomfact" rows="2" cols="15" align="center" class="grand champs_fieldset"></textarea>
			<p><label for="qualite-fact" >Qualité :</label><input type="text" name="qualite-fact" id="qualite-fact" class="moyen champs_fieldset"/></p>
			<label for="adresse-fact">Adresse :</label>
			<textarea name="adresse-fact" id="adresse-fact" rows="3" cols="50" align="center"class="grand champs_fieldset"></textarea>
			<p>
			<label for="codepostal_fact" >Code postal :</label><input type="text" name="codepostal_fact" id="codepostal_fact" class="moyen champs_fieldset"/>
		<label for="ville" class="c2">Ville :</label><input type="text" name="ville" id="ville" class="grand"/>
		</p>
		<p>
		<label for="tel1-fact" >Téléphone 1 :</label><input type="text" name="tel1-fact" id="tel1-fact" class="grand champs_fieldset"/>
		<label for="fax-fact" class="c2">Fax :</label><input type="text" name="fax-fact" id="fax-fact" class="grand"/>
		</p>
		<p><label for="tel2-fact" >Téléphone 2 :</label><input type="text" name="tel2-fact" id="tel2-fact" class="grand champs_fieldset"/></p>
		<p><label for="email-fact" >E-mail :</label><input type="text" name="email-fact" id="email-fact" class="grand champs_fieldset"/></p>
	   </fieldset>